甲减合并冠心病的中医体质与危险因素调查研究OA

Objective To recognize and intervene early and delay the progression of the disease,the distribution characteristics and risk factors of Chinese medicine constitution in hypothyroidism combined with coronary heart disease(CHD)was investigated and analyzed.Methods Patients with CHD who attended the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from October 2022 to July 2023 and underwent thyroid function tests were taken as observation subjects.The group was divided into a hypothyroidism group and a non-hypothyroidism group based on the presence or absence of comorbid hypothyroidism.Data including basic condition,medical history,degree of coronary artery lesion and revascularization,medication use,laboratory indices,cardiac function scores,and Chinese medicine physique were collected.A retrospective study of 443 patients who met the inclusion over exclusion criteria and had complete information was finally conducted.There were 141 cases in the hypothyroid group and 302 cases in the non-hypothyroid group.The information of the two groups was subjected to single factor analysis.Factors with statistically significant differences were screened for inclusion in a binary logistic regression model to finalize the influencing factors.Results The proportion of Chinese medicine constitution distribution in patients with hypothyroidism combined with CHD was as follows:Yang-deficiency constitution=Qi-deficiency constitution>Blood stasis constitution>Phlegm-dampness constitution>Qi-depression constitution>Pinghe constitution>Yin-deficiency constitution>Special constitution>Damp-heat constitution.And Qi-depression constitution accounted for a higher proportion in female patients with hypothyroidism combined with CHD than in males(P<0.05).The proportion of Yang-deficiency and Qi-deficiency constitution was higher in the hypothyroidism group than in the non-hypothyroidism group.Whereas,Yin-deficiency and Damp-heat constitutions accounted for a lower percentage than the non-Hypothyroidism group(P<0.01).The results of binary logistic regression indicated that anxiety status,depression status,thyroid nodules,angiotension converting enzyme inhibitors(ACEI)/Angiotensin Ⅱ receptor blockers(ARB)drugs,decreased left ventricular diastolic function,degree of coronary artery stenosis,undergoing revascularization,Thyroid Peroxidase Antibodies(TPOAb),TgAb,CRP,and Yang-deficiency constitution were strongly associated with hypothyroidism combined with CHD.Conclusion Yang-deficiency constitution,Qi-deficiency constitution,blood stasis constitution,phlegm-dampness constitution and Qi-depression constitution are highly prevalent in patients with hypothyroidism combined with CHD.Anxiety and depressive states,thyroid nodules,decreased left ventricular diastolic function,degree of coronary artery stenosis,TPOAb,TgAb,CRP,and Yang-deficiency constitution are risk factors for hypothyroidism combined with CHD.In contrast,the use of ACEI/ARB drugs and performing revascularization were protective factors for hypothyroidism combined with CHD.